Educational

We as health professionals emphasis on the importance of patient safety. What is patient safety and why it is important?

According to several published studies, if a hospital has a safe patient culture they will have less medical errors and increased patient satisfaction.
According to world health organization “patient safety is the absence of preventable harm to patient during the process of healthcare”, and according to Wikipedia, patient safety is “a discipline that emphasizes safety in health care through the prevention, reduction, reporting, and analysis of medical errors that often leads to adverse effects”.

After prolonged surveys and study’s by WHO they found several types of medical errors which lead to harm to the patient that can be prevented. Then they prioritized these errors according to likelihood of happening. After that through evedince-based practice they established set of interventions that would help healthcare organizations to stop these errors from happening or reaching the patient and cause harm, this set of interventions are called patient safety solutions.

National accreditation standards for hospitals lists them as Patient Safety Required Areas (PSRA) for the hospital to be accredited.

These Patient Safety Required Areas are:

1- Patient verification

2- Transfer of patient information at transition point

3- Medication reconciliation

4- Safe surgical practices

5- Control of concentrated electrolytes

6- Training on patient safety

7- Hand hygiene

8- Timely administration of prophylactic antibiotics

9- Safe injection practices

10- Performance of correct procedure at correct body site

11- Look alike sound alike medication names

12- Avoiding catheter and tubing misconceptions

Finally, I would like to thank Quality and Accreditation Directorate for conducting Kuwait Conference on Quality in Healthcare in the Regency Hotel on the 13th to 15th of March 2017, under the patronage of his excellency Dr. Jamal Al-Harbi, the minister of health in Kuwait. The conference was held during world patient safety awareness week, which is dedicated to educate and spread awareness about the importance of having patient safety culture in healthcare organizations.

The conference program was about:

1- Exchange quality improvement experiences

2- Generate momentum for change in your organization

3- Learn latest quality improvement issues, tools, and techniques

4- Network with like-minded colleagues

So thanks to all of the organizers who made it happen, thanks to all the speakers who made it interesting, and a big “Thank You” to all who attended, you made the conference serve it’s purpose.

We are in march and worldwide is dedicated for the education of MS. Let’s first explain what is MS?it is the short name off multiple sclerosis disease. It is an inflamatory iimmune disease with unknown causes, it attacks the myelin sheath which in the nerve fibers which is responsible for transmitting nerve impulses from the spinal cord to the brain.

The symptoms varies from person to person, but the most common symptoms are:

1- Sensory loss

2- Muscle spasms

3- Bladder and bowel incontinance

4- Vision problems

5- Depression

6- Concentration and memory problems

Diagnosis of MS consist of:-

– Clinical examination to identify related symptoms

– Then the patient has to do an MRI and sometimes lumbar puncture

The aim of treatment is to delay the progress of the disease and reduce the symptoms

Now I have MS what do I feel? What to do next?

Patients who suffer from MS, their main complain is like they ares loosing control of their body, this is as a result of poor communication between the nerves.

What to do next? Let us elaborate on that:

1- Do not give up, you are not alone. Being in a support group helps the patient psychologically.

2- Relax; getting periods of rest will ease the symptoms

3- Exercise will help you in maintaining muscle tone and strengthen the body to keep the balance and coordination.

4- Try not to be exposed to extreme temperatures especially heat, hot temperatures can aggravate symptoms, when you experience this situation try to apply cold compresses to reduce the symptoms.

5- Like all chronic illnesses, keeping nutrients as well as a balanced diet is important to provide the body with adequate nutrients.

If you are reading this and expecting medical information then you’re mistaking.

This time there are no medical terms, no diagnosis, no medications, and no teaching.

This time I am going to take you on a trip. So fasten your seatbelt…

Imagine your self walking down the street normally and about to enter a resturant to meet friends for lunch. Just before entering the resturant, a fight breaks out between some random people out side the resturant. Any normal person would either just avoid the fight go inside the resturant or like most of stand and watch the flight and take a video. Well, that is what you and I might likely do. But, a person with multiple personality disorder would get so scared that they change into a whole different person. When I say a different person I really do mean a totally different person. One minute you are a nurse and the next you are a professional karate instructor.The change in personality is so extreme that it could be unbelievable to us. So, when the change of personality occurs, you block out the previous personality.

So, lets imagine the First personalty to be a 25 year old you lady and she is a nurse. The fight she saw gave her a fright that in turn triggered a personalty change. From a nurse to professional karatee instructor. Now we go back to the fight next to the resturant. I guess our karate instructor is not very self- disciplined, because she joined the fight.

Of course in any fight someone is going to call the police. Police comes, they break the fight, ask qurstions, arrest people. Normal police work. But, to the surprise to the police, they find out that they arrest a kid! Yes yes a kid…

well our nurse that changed to a karate instructor turned to a kid. Well, she did not shrink in size and changed into a kid literally, we are not not talking about shape shifters her, only personalty changers.

Fear changed the nurse to a karate instructor, and just seeing the poilce changed the karate instructor into a kid. The police find their selves dealing with a kid. A kid, a little boy 5 years in the body of a 25 year old woman. The kid just cries and cries asking for his patents. Most police men will not know what to do in cases like this, they arrest someone from a fight, by the time they get to the station they’re dealing with a kid. So, the police either call they mental hospital, a psychiatrist, or just call any number they find with the kid.

For case of the story, let say the police turned the kid to the mental hospital. Of course, they found an ID on our character. In the mental hospital, after checking the name with the records, turns out our person here is a regular patient.

A couple of hours after being in the hospital, again comes a personality change. The real main person comes out. A 35 year old woman, and shes a cheif! When she goes back to her real personality, she is so depressed. The depression is mainly because she knows that she blocked out turned to another person with amanother life, except she doesn’t remember what happened, what she did or where she was.

So here our main personality is the chief which is usually called a host. The term host is used because of course the person hosts the other personalities.

In this case the host is the 35 year old chief, the protector is the karatee instructor, the nurse is the down to earth person the loving and caring, and a kid.

So.. this is how a person with multiple personality would spend a day. Scary right. And do not forget some people have up to 10 personalities maybe more. Some have learned to control their personalities, and they know what triggers and alters their personality change.
Well at the end.. I hope I did not lose you with the jumping from one personality to another. This is just reading imagine living like this. .

​Rare disease day is an important event that seeks to create awareness to the public. In this particular day patients and the world population are educated on how they can handle this diseases so that they can reduce its effect. The day was started in the year 2008 and several people in the world were involved in undertaking different activities. The day is takes place on the last day of February each and every year. Those who are involved in activities of this day have the objective of ensuring that awareness about the rare diseases.

​The general public and the decision makers discuss much about the different effects that the disease has on the lives of the patients. The major target of the campaign is the public authorities, researchers, policy makers, industry representatives, health professionals, and all those who have interest in rare diseases in ensuring that they have raised awareness amongst them. It is meant to ensure all stakeholders are equipped with up to date knowledge on how to deal with the disease. When all the stakeholders are involved it means that they will engage in advanced discussions that will bring advanced solutions in handling the rare disease (Jerome, 2007).

Some examples of the Rare disease include:

cystic fibrosis, Huntington’s disease, muscular dystrophies, Acrocephalosyndactylia, Amylose and Brown-Sequard Syndrome. Rare diseases are also sometimes called orphan diseases. One of the most interested Rare Disease is the Huntington’s disease.

Huntington’s disease is an inherited disease that causes the progressive breakdown (degeneration) of nerve cells in the brain. Huntington’s disease has a broad impact on a person’s functional abilities and usually results in movement, thinking (cognitive) and psychiatric disorders.

Other medications that may help suppress chorea include amantadine, levetiracetam (Keppra) and clonazepam (Klonopin). At high doses, amantadine can worsen the cognitive effects of Huntington’s disease. It may also cause leg swelling and skin discoloration.

People with Huntington’s disease often have difficulty maintaining a healthy body weight

Difficulty with chewing, swallowing and fine motor skills can limit the amount of food you eat and increase the risk of choking.

​All over the world, the Rare Disease Day events are carried out by hundreds of patients and organizations. The work of those that are involved at the local and national levels is to ensure that there is increased level of awareness amongst the communities that they live. From the first day that the Rare Disease Day was started by EURORDIS and its Council of National Alliances in 2008, there has been thousands of events have been undertaken all over the world. This has been able to reach several people, who are estimated to be hundreds of thousands.

​The results have been magnificent since the media has been supportive due to its comprehensive coverage. There are several official rare disease day partners that are involved in ensuring that the day is success. They act as partners and also form a national alliance to ensure everything is a success. The bodies are the ones that come together to form organizations in different regions and countries to ensure they carry out successful events on the long run. They carry out this in ensuring that there is sufficient coverage that will ensure everything runs as expected (Zander, 2009).

​Since the first event that was carried out, there has been several developments that have come up that have led to making the Rare Disease day very important in the world calendar of events. This has been from the different developments that the stakeholders have yearly come up with making it impossible for it to be ignored anymore. Yearly, there has been new unfolding events that make the day more interesting and viable to the patients and stakeholders. There is a very important link between the understanding the effects of the disease on the patient life. The event yearly has transformed the perception of the disease and new ways of handling the disease have been developed (Zurinsyki et al. 2008).
​There is insufficient means of dealing with the rare disease. Therefore, it is necessary that continuous cooperation among stakeholders is necessary. From last year’s events, there is need to make continuous discovery and development of better methods meant to ensure that the disease is better dealt with. There is necessity to ensure that patients are made aware of actions that are going to assist them in dealing with the condition. The other stakeholders who have the responsibility of dealing with this condition should ensure that everything meant to ensure that all the things are in place to make patients comfortable (Luce, 2009).

​The day should be undertaken in a way to ensure that those families that have been affected by the diseases are involved. The general public and the decision makers should discuss much about the different effects that the disease has on the lives of the patients. The major target of the campaign is the general public, public authorities, researchers, policy makers, industry representatives, health professionals and all those who have interest in rare diseases in ensuring that they have raised awareness amongst them. All these is meant to ensure all stakeholders are equipped with up to date knowledge on how to deal with the disease. When all the stakeholders are involved it means that they will engage in advanced discussions that will bring advanced solutions in handling the rare disease.

Toothache is a pain that occurs around the tooth, it usually happens in the worse circumstances, the pain is intolerable, and it may affect all over the face. i can not think of anyone who did not have it, no matter the age, in one point of your life you will get it.

Causes:

The most common cause is tooth decay, but it can be other causes such as:

Trauma to the tooth

Infection

Gum disease

And more serious causes like heart attack, or angina.

When to go to the dentist:

The question we all wonder about is when we seek medical advise for toothache? according to e medicine health they recommend to seek help when:

Start to have fever

Swelling of gum, teeth, or throat with difficulty swallowing

The pain is not relieved with over the counter medication

If the person has previous medical history

Home remedy:

To be completely honest lets face it, the first thing most people do when they have toothache look for traditional home remedies. some of these remedies are been advised by Arizona family dental:

A feeding tube is a medical tool used to assist patients that can not consume their complete nutrients orally. There are serveral types of feeding tubes, each with it’s own special specifications and indications. It all depends on the patient’s needs and conditions.

When we talk about patients/people that require feeding tubes, what comes to minds usually are those patients that are at the last stages of their lives. But, thats is completely wrong. Feeding tubes can be used for new born babies (immature) all the way to the bedridden 100 years old folks. The duration of which these tubes are kept in the body, are either short term or long term, again all depending on the condition of the patient.
Some conditions are:

Nasogastric tube: it is a tube that is inserted into the nose down to the thraot and into the stomach. Can be used for feeding, medications, and also to empty the stomach. Of course the placement of the tube should be checked before each feeding.

Nasoduodenal tube: which is similar to the nasogastric tube, except it goes all the way through to the first part of the small intestines, the duodenum. It is usually used when the patient is at risk for aspiration.

Nasojejunal tube: again similar to the two previous tubes, except this one goes further into the small intestine; the jejunum. Usually used for patients that have chronic vomiting, or patients that aspirate food contents into the lungs.

Gastrostomy tube: this tube requires surgical intervention for insertion. A hole called a stoma is made into the stomach. Into the stoma a tube is inserted with a ball that fills with water for securing placement.

Jejunostomy: also requires a surgical procedure, the stoma is all the way to the jejunum.

How to give the feed:

In most cases patients with these tubes are hospitalized. In that case, there should be any worries.As the patient is surrounded by medical personnel that are solely responsible for ensuring the placement, and the functional status ofbthe tubes. And the correct feed and feeding method. And also the right way to feed. The feed could be continuous on a feeding pump, or every certain amount of hours that could be programmed on the feeding pump. Also, can be given as a bolus push. The classification and brand of feed is determined by the dietitian.

In the case of the patient uses one these feeding tubes at home, education is the most important part. And this is where the nurse plays an important part in educating the patient or the care giver. Before starting starting to educate the patient and the family and even before the insertion of the tubes, the patient must understand what’s happening. It is very important that the patient him self knows about the procedure and the purpose of it. The patient and family have to accept the change of life style that they will encounter.

What are some important health education that the patient needs to know?

The patient/family needs to know the importance of feeding and nutrition it self, and the consequences of deprivation of food and nutrients.

Takeing care of the tube and handling it. Of course the education will be given according to the tube inserted.

Keeping the tube and area clean all the time.

Washing hands before and after handing.

Knowing how to keep the tube secured, and what to do if the tube is dislodged .

Learning about the feed being used and the proper way to administer it( feed pump, syringe pump, bolus)

Knowing how to administer medicine through them

If a feeding pump is used, the patient/family must know how to operate it.

To report any kind of pain, or discharge like pus or even leakage from the site.

Bon Appétit!

References:
*, N. (2013, November 1). Types of feeding tubes and terms to know by the feeding tube awareness foundation. Retrieved February 8, 2017, from https://globalgenes.org/raredaily/types-of-feeding-tubes-and-terms-to-know-by-the-feeding-tube-awareness-foundation/
Retrieved February 8, 2017, from http://www.nhs.uk/ipgmedia/National/Macmillan%20Cancer%20Support/assets/Nutritionalsupport(artificialfeeding)(CB7pages).pdf

Leprosy is a chrinic bacterial infection that is progressive if left untreated. Leprosy affects the skin mainly, stating with uneven flat leasions. The disease also affects the peripheral nerves in the hands and feet.Even the mucus membranes are affected, which are the small opened areas in the body like the eyes, nose, and throat. The diease can spread from one person to another my droplets ( coughing, sneezing). It may affect anyone there is no age limit nor a specific population.

Leprosy starts off with small lesions on the skin. The lesions become numb because of the loss of sensation in them, due to the distruction of nerve endings. Mutations occur to the fingers and toes because of the loss of sensation , that my cause them to fall off.

A person with Leprosy disease, can be recognized by their appearances sometimes. As the disease causes very obvious deformities. Some of the signs and symptoms that can be easily noted are the skin lesions previously mentioned. Lesions have uneven edges, spreads all over the body, and the color is faded and lighter than the normal skin. The areas with these lesions will have loss of sensations and numbness. There will be extra growth of skin, that protrudes out. The protrusions of skin is dry, thick, and stiff. Patients may experience severe pain and muscle weakness, or ever paralysis. Blindness could also be cause by leprosy. Other signs and symptoms are nosebleeds, stuffy nose, feet ulcers.

Leprosy can be diagnosed by a skin smear. The disease can be cured and treated if medications are started fast. The treatment of leprosy consist of three antibiotics that are prescribed together. The duration of the treatment may last up to 12 months. Fortunately, the WHO took a great step to reduce the spread of the disease, and made the treatment available for everyone everywhere.